Categories Health Care

I just got out of a press conference with Congressman Joaquin Castro, San Antonio Mayor Julian Castro, Dallas County Judge Clay Jenkins and other Democratic leaders who urged Governor Perry and Republican leadership to accept Medicaid expansion.

Earlier this morning, Governor Perry, U.S Senator John Cornyn, and U.S. Senator Ted Cruz took a stubborn stand against the expansion. Governor Perry was quoted by the Dallas Morning News as saying “Texas will not be participating in Medicaid expansion.”

Political stunts like the one held today by Governor Perry make it clear that he is not getting the message. We need to stop playing politics with the health of our constituents. There is too much is at stake. We’ve tried Governor Perry’s plan for 12 years, and after 12 years of Governor Perry’s failed health care policies, we have the highest rate of uninsured in the nation with 6 million Texans without insurance. It’s time for a new plan. It’s time to expand Medicaid. If Republican Governors in Arizona, New Jersey, and Florida can put partisan politics aside and do what is best for their citizens, Texans have every right to expect their leaders to do the same.

It is the right thing to do for the 1.8 million Texans who will receive coverage. It’s the smart thing to do because of the $68 billion economic impact that would take place in just three years.

Congressman Castro challenged Governor Perry to “give up the swagger and get serious about Medicaid expansion.” I hope he heeds that call.

Last week, despite previously opposing Medicaid expansion for his state, Florida Governor Rick Scott bowed to reality and common sense: he said Florida will participate in the expansion of Medicaid under the Affordable Care Act (ACA). Scott said that he “could not in good conscience deny the uninsured access to care.” As a result of Scott’s decision, about 1 million Floridians who are currently uninsured will now have health care access through Medicaid.

Scott is not alone in reaching the conclusion he did. Florida joins Ohio, Arizona, Michigan, Nevada, New Mexico and North Dakota – all states with Republican governors – in saying it will opt into Medicaid expansion, drawing down billions of dollars they are entitled to under federal law and dramatically reducing their uninsured population in the process.

Do you notice a rather large state with a GOP governor missing from this list?

There is not a state in the country that would benefit more – both in the total number of dollars received and in reduction in the total number of uninsured – — than Texas. Scott’s decision gives me some hope that if we keep up the pressure on our own Republican leadership and appeal to both good conscience and common sense, Texas will also join the ranks of states who decide to expand Medicaid.

These other states have already figured out what our state leadership has not or is unwilling to admit – that Medicaid expansion is good for the states and good for the country. As a result of the ACA, Texas will receive more than $100 billion from the federal government in exchange for investing just $15 billion in state funds over the next decade. According to Governor Perry’s own administration, 1.8 million Texans will receive health care coverage under the expansion, and more than 90 percent of it will be paid for by the federal government. And if the health care argument is not enough, consider the economic impact: according to a study by the Perryman group, Texas will see a positive economic impact of $67.9 billion during fiscal 2014-17. Closer to home, a report commissioned by Texas Impact and Methodist Healthcare Ministries shows that Medicaid expansion will generate $14 million in new, local tax revenue in House District 101 alone from 2014 through 2017.

Even as we work toward expansion of Medicaid under the ACA, there are some positive changes coming to Texas, no matter what our Republican leaders say. Just this past week in the Insurance Committee, I learned that there are positive elements of the ACA already being implemented . For example, starting in 2014, Medicaid participants will only have to enroll every 12 months, as opposed to six. The assets test, which unfairly penalizes many applying for Medicaid coverage, will also be abolished in 2014. These are important reforms to Medicaid that will help people across our state and in our district, and I am happy to see them taking place.

The stakes are high for Texas. With nearly a quarter of our state’s population without coverage, we have the highest uninsured rate in the nation, a sad fact that costs all of us, whether we have insurance or not. Faith-based, medical, and even business groups are joining in the call to the Republican leadership to do the right thing for Texas and accept Medicaid expansion. I remain hopeful that by speaking up and speaking out, good conscience and common sense will prevail.

With the highest rate of uninsured in the nation and Texas ranked dead last among the 50 states in health care delivery, there’s no shortage of improvements to be made to the state’s health care system. The good news is that Texas has the tools to expand access to affordable health care – it’s called the Affordable Care Act (ACA), which has been upheld by the Supreme Court. Chris believes that Texas should use the ACA smartly to get the maximum benefit for the state. Chris will work with his colleagues in the Texas House to gain support to accept the Medicaid expansion. Under ACA, states can enroll their citizens in Medicaid if their annual income is 133 percent of the poverty level (about $30,000 for a family of four) or less. Under this provision, about 1.5 million Texans would gain coverage.

Chris also supports expanding the Children’s Health Insurance Program (CHIP) in order to decrease the number of uninsured children in our state. In 2009, Chris co-authored a measure that would expand CHIP eligibility to include children whose family incomes are between 101 to 300 percent of the Federal Poverty Level. Chris will work to extend the Medicaid enrollment period from six months to one year, as it is in most other states.

I wrote the email below over the weekend. This morning, we learned that Governor Rick Perry is making the shortsighted and ill-informed decision to not pursue Medicaid expansion or set up a state insurance exchange under the Affordable Care Act. The governor’s announcement is about politics, nothing more, and will only serve to lengthen Texas’ unfortunate reign as the state with the highest rate of uninsured. I’ll have more to say on his announcement later, but for now I wanted to share my original email, and why it’s so important that Texas get this right.

Campaigns are generally not known for enhancing healthy lifestyles. You tend to eat a lot of fast food, and the hectic pace crowds out one’s time at the gym. At least that’s been my experience. Having recovered somewhat from a long campaign, I dragged myself to the gym early this morning for the first time in a few months. And while it wasn’t easy getting up at 5:00 am to go to the gym, I take some solace knowing that by having a plan and some discipline in exercise and diet, I can lose the few (OK, several) pounds I gained the last few months, feel better and be healthier. Short term pain, long term gain, as they say.

Just like I need to have a plan and some discipline to get healthier, so does Texas. With the highest rate of uninsured in the nation and a troubling new study out last week that showed Texas ranks dead last among the 50 states in health care delivery, there’s no shortage of improvements to be made. But here’s the good news: just like I have tools to get healthier (a gym, a running trail nearby and better food choices), so does Texas – it’s called the Affordable Care Act (ACA), recently upheld by the Supreme Court. But just like my gym membership that’s worthless when it goes unused, Texas must use the ACA smartly to get the maximum benefit for our state. Here’s how:

Set up an insurance exchange. The ACA calls for setting up an insurance exchange in each state so that folks without employer-based coverage can shop for plans (this is not dissimilar to the way we buy electricity for our homes in Texas). If the state does not set up an exchange, the federal government will do it for us. It should be a no-brainer that we would set up our own system, instead of having a “one size fits all” set up by the feds. But since Texas Republican leaders killed efforts to set up an exchange last year, that is exactly what will happen unless we reverse course and get it together, fast.

Accept the Medicaid expansion. This is the big one for Texas – with the highest rate of uninsured in the nation, we have the most to gain from this. Under ACA, states can enroll their citizens in Medicaid if their annual income is 133 percent of the poverty level (about $30,000 for a family of four) or less. We could insure about 1.5 million people in Texas under this provision.

And what would that cost the state of Texas? For the first couple of years, the federal government funds the entire expansion. Eventually, Texas would be responsible for paying 10 percent of the cost. A 9:1 match is hard to beat – and it would be an outrage for Texas not to claim its fair share of funding under the law, especially when our need is so great.

I am looking forward to serving in the Legislature next year, and working with fellow lawmakers to make the ACA work for Texas. If we identify the problem (the uninsured/poor access to care), set some goals (reduce the rate of uninsured/improve access), develop a plan (implement the ACA) and have some discipline (focus on reform, not false rhetoric about socialism and government takeovers of health care) we’ll make a real difference in the quality of life for millions of Texans. And by reducing the ranks of the uninsured, we can drive down premiums for everyone else. After all, we’re already subsidizing emergency care for the uninsured with high premiums and tax support for public hospitals.

To lose weight, I have to follow a pretty simple formula: burn more calories than I consume.

To make Texas healthier, it’s nearly as simple: reduce the rate of uninsured and improve access.

Both just require some willpower – and a plan.

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